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05-071 (2) Component Loads Property Organization 67 Grove Ave HIS& HERS Energy Eff ici, Leeds, MA 01053 4136588784 Inspection Status Adin Maynard Results are projected Sparkle Modular-Prelim-10-3 Sparkle residence Builder Bucky Sparkle Heating & Cooling Loads 10 8 6 4 cts 0) 2 0 -2 -4 .6 Above-Grade Infiltration & Slabs& Roofs Ducts Windows& Foundation Internal Walls Ventilation Floors Doors Walls Gains Heating 0 Cooling ■ Ekotrope RATER-Version 3.1.0.2D1 8 This information noes not emstimo a warranty or guarantee of hw**g energy performance. Building Specification Summary Property Organization 87 Grove Ave HIS& HERS Energy Effici, Leeds, MA 01053 4136588784 inspection Status Adin Maynard Results are projected Sparkle Modular-Prelim-10-3 Sparkle residence Builder Bucky Sparkle Building Information Rating Conditioned Area[sq. ft] 2,792.00 HERS Index 29 Conditioned Volume[cu.ft.] 24,932,00 HERS Index w/o PV 29 Thermal Boundary Area[sq. ft,] 5.540.90 Number Of Bedrooms 2 Housing Type Single family detached Building Shell Ceiling w/Attic None Windows(largest) U-Value:0.19,SHGC:0.19 Vaulted Ceiling R58, SIPS-12-Murus U-0.02 Window/Wall Ratio lo.11 Above Grade Walls Infiltration 1 ACH50 R4010" DSW-16oc-VERMOD-R36nmnI U-0.03 Duct Lkg to Outside Untested Found.Walls ICF, R24 Logix R2 R-24 Total Duct Leakage Untested Framed Floors R38, 12-16,Cell R-42 Slabs R30 under XPS R-30 Mechanical Systems Heating Air Source Heat Pump- Electric-3.66 COP Cooling Air Source Heat Pump-Electric-26.1 SEER Water Heating Water Heater-Electric-2.7 Energy Factor Programmable Thermostat Yes Ventilation System 50.4 CFM-62.0 Wafts Lights and Appliances Percent Interior LED 1000/0 Clothes Dryer Fuel Electric Percent Exterior LED 10 fto Clothes Dryer CEF 3.7 Refrigerator(kWh/yr) 688.0 Clothes Washer LER (kWh/yr) 130.0 Dishwasher Efficiency 256 kWh Clothes Washer Capacity 4.0 Ceiling Fan None Range/Oven Fuel Electric Ekatrope RATER-Version 3.1.0.21318 This irdormation does not constitwe a warranty or guarantee of home energy pvtormarce, Fuel Summary Prop" Organization 87 Grove Ave HIS&HERS Energy Efficient Leeds,MA 01053 4136588784 Inspection Status Sparkle Modular-Prelim, 103 Adin Maynard Results are projected Sparkle residence Builder Bucky Sparkle Annual Energy Cost Electric $1,542 Annual End-Use Cost Heating $288 Cooling $24 Water Heating $114 Lights&Appliances $1,057 Onsite Generation _$0 Service Charges $60 Total $1,542 Annual End-Use Consumption Heating [Electric kWh] 1,602.2 Cooling [Electric kWh] 131.4 Hot Water[Electric kWh] 634.7 Lights&Appliances[Electric kWh] 5,8761 Total[Electric kWh] 8,244.4 Total Onsite Generation kWh 0.0 Peak Electric Consumption Peak Winter kW 1.32 Peak Summer kW 1.23 Utility Rates Electricity Eversource-MA_201 8,Jan_$O.l 8 Ekotrope RATER-Version 3.1.0.2018 This information does not conSttute a warranty or guarantee Of home energy pertormanca, Home Energy Rating Certificate Rating Date: 2018-09-28 Registry ID: Unregistered Projected Report EkotropeID: YLewwDBv HERS' Index Groveout home's HERS score Is a relative 87 ! performance score.The lower the number, the mote energy efficient the home.To $4y977 Builder: 29y1earn more,visit www.hersindex.com *Relative to an average U.S.home Bucky Sparkle Your Home's Estimated Energy Use: This home meets or exceeds the Use[MBtu] Annual Cost criteria of the following: Heating 5.5 $288 Cooling 0.4 $24 Hot Water 2.2 $114 Lights/Appliances 20.0 $1,057 Service Charges $60 Generation(e.g.Solar) 0.0 -$0 Total: 28.1 $1,542 HERS • Home Feature Summary: Rating Completed by.- 4111111111- n•ve,*ra, Home Type: Single family detached Energy Rater.Adin Maynard rso Conditioned Floor Area: 2,792 sq.ft. RESNETID:9463452 Exing1�O Number of Bedrooms: 2 ISO Rating Company:HIS&HERS Energy Efficiency 120 Primary Heating System: Air Source Heat Pump•Electric.•3.66 COP Mailing:12 Perkins Ave.Northampton MA 01060 Reference uo Primary Cooling System: Air Source Heat Pump-Electric-26.1 SEER 4136588784 Home 100 Primary Water Heating: Water Heater•Electric.2.7 Energy Factor 90 House Tightness: 1 ACH50 Rating ProviderEnergy Raters of Massachusetts Ventilation: 50.4 CFM•62.0 Watts 2 Woodlawn Street Amesbury,MA 01913 978-270-3911 �+ Duct Leakage to Outside: Untested b Above Grade Walls: R-38 Ceiling: Vaulted Roof,R-58 This Home Window Type. U-Value:0.19,SHGC:0.19 zeroen 0 Foundation Walls: R-24 w.r Adin Maynard,Certified Energy Rater Digitally signed: 1013/18 at 1256 PM d(otro0 ,. .. i • • • s • Disclosure •r this house Is available . ti r providet. Cft Of Louis Hasbrouck<Ihambmuch@modhamptommu.gov> AN 0 Re: buckwsparkle shared "Sparkle Plans ~ 18079 [MA] Final TRA _pdf, with you ` message Louis Hasbrouck<ihosbmunk@nodhomptonmagov> Wed,Oct 31.2O18ot553PM To:buckysparkle<zygmdichuohy@gma||.com> Got them. When wolook etthe set,woneed 0osee that the set crew is approved,and mostly that the module numbers match and that they're attached hothe foundation and each other per drawings(plan page a-01) Another thing;even though it's a modular,the house does need a HERS rating.The rescheck isn't enough. I'm sure of that because it came uprecently and}checked with the BBRS|nBoston. |don't know how much itWi||cost;the raters have been going over the plans and inspecting and doing blower door tests after the units are set. Louis Hasbrouck Building Commissioner City ofNorthampton Town ofWilliamsburg (413)587-1240 office (413)587-1272fax DnWed,Oct 31.2O18ek8:52AM, buokysparkle(via 0mpbox)<no-mp|y@dmpbox.com>wrote: � Hi Louis, � bucky sparkle (zygotimai\zmn) invited you to view the file | "Sparkle Plans ' Y8079 [MWk] Final TRA Ap 'm60 onDroobox. buckvsaid: "Louis, this morning/dropped off the application and paper plans. FDFs are attached to this message.please let meknow ifyou have questions, brighdKbudyzen0ineedbuckv@gma8con7^ � � � Enjoy! The Dropboxteam � bucky and others will beable to see when you view this file. Other files shared with you through Dnopboxmay also show this info. Learn � more/nour help center. | Report hoDmpbux 2018Drophmv Above-Grade Wali 0.00 Seiow-Grade Wall 40.00 Floor 0.00 Calling /Roof 60.00 Ductwork(unconditioned spaces): Window o.2o Door 0.12 • •a • 4 Heating System: Cooling System: Water Heater: Name: Date, Comments T R ARNOLD!ASSOCIATES,INC. 4709 CHUM DR E,LKHART,IN 46516 st,.Wsy MASSACHUSETTS Accredited Evaluation and Inspection Agency This(ImMat is mranad as berg in m-ft- •ah sate erring codas. Date SEPTEMBER 66,2018 llpproVd d ais d—ii does na adhahe a aW" ary,msom a dMaim/mm ih•ta4*—u d SUaelws. , Section Plans Verified Field Verified # Fina!Inspection Provisions Value Value Compiles? Comments/Assumptions +�Req.la 401.3 Compliance certificate posted. OComplies Requirement will be met. (FI712 ODoes Not ONot Observable ONot Applicable 303.3 Manufacturer manuals for OComplies Requirement will be met. (FI1813 mechanical and water heating Oboes Not systems have been provided. []Not Observable ONot Applicable Additional Comments/Assumptions: T.It MMOLD:ASSOCUTM INC. 47x1 CRUTr.R DR nJa1ART,IN 46316 States? MASSACHUSETTS Accredited Evaluation and Inspection Agency THs do—et is cen(ne u being in catmnams r M 4Nde cedes. Dew SEPTEMBER Ob.2018 .tppwdde b tloonPt d—notaue.etae--W— arty anesspn otdaViehn tram te:ren,Afarerilx d 5te0t lwwz. 1 High Impact(Tier 1) 12 IMedium Impact(Tier 2) 3 Low Impact{Tier 3) Project Title:Sparkle Residence Report date: 08/20/18 Data fliename:CAUserskccraft\DocumentsW18 CLIENT FILESIMisc.Projectslres check 17013 Page 10 of 10 Spa rkle.1,rck Section Plans Verified Field Verified # Final inspection Provisions Value Value Complies? Comments/Assumptions &R ID 403.6.1 AN mechanical ventilation system OCompiies Requirement will be met. [FI2512 fans not part of tested and listed ODQes Not HVAC equipment meet efficacy []Not Observable and air flow limits ONot Applicable 403.2 Hot water boilers supplying heat OComplies Exception:Requirement is IF12612 through one-or two-pipe heating []Does Not not applicable. systems have outdoor setback control to lower boiler water [riot Observable temperature based on outdoor ONot Applicable temperature. 403.51.1 Heated water circulation systems OCompiies Exception;Requirement is (FI2812 have a circulation pump.The Oboes Not not applicable. system return pipe is a dedicated URARNOLo&ASSOCiATES.INC. return pipe or a cold water supply ©Mot Observable pipe.Gravity and thermos- e�nx�r.aas°u ONot Applicable syphon circulation systems are sieWg) MASSACHUSETM not present.Controls for Accredited Evska ion MW circulating hot water system Inspection Agency pumps start the pump with signal „w ;—,d.,,V„9— for hot water demand within the .4h S�kdft C.4– occupancy.Controls DM%SEPrEMMR 05,Will automatically turn off the pump when water is In circulation loop apww L` is at set-point temperature and no demand for hot water exists. 403.5.1.2 Electric heat trace systems ❑Complies Requirement will be met. 1F12912 comply with IEEE 515.1 or UL ODoes Not 515.Controls automatically E3Not Observable adjust the energy input to the heat tracing to maintain the ONot Applicable desired water temperature In the piping. 403.5.2 Water distribution systems that OComplies Exception;Requirement is [F13012 have recirculation pumps that ©Does Not not applicable. pump water from a heated water supply pipe back to the heated []Not Observable water source through a cold ONot Applicable water supply pipe have a demand recirculation water " system.Pumps have controls that manage operation of the pump and limit the temperature of the water entering the told water piping to 1049F. 403.5.4 Drain water heat recovery units OCompiies Exception:Requirement is [F13112 tested in accordance with CSA Oboes Not not applicable. 855.1.Potable water-side pressure loss of drain water heat ONot Observable recovery units<3 psi for ONot Applicable individual units connected to one or two showers.Potable water- side pressure loss of drain water heat recovery units<2 psi for Individual units connected to three or more showers. 404.1 75%of lamps In permanent OComplies Requirement will be met. [F1611 fixtures or 75%of permanent ©Does Not fixtures have high efficacy lamps Does not apply to low-voltage ONot Observable lighting. ONot Applicable 404.1.1 Fuel gas fighting systems have OCornp[les Requirement will be met, (Fi2313 no continuous pilot light. Oboes Not ONot Observable ONot Applicable 1 I High Impact(Tier 1) 2 Medium Impact(Tier 21 3 Low Impact(Tier 31 Project Title.Sparkle Residence Report date: 08/20118 Data filename:C:1Users\ccraf\Documents\018 CLIENT FILESkMisc.Projects\res check 17013 Page 4 of10 Sparkie.l.rck Section Plans Verified Field Verified # Final Inspection Provisions Value Value Complies? Comments/Assumptions 402.1.1, Ceiling insulation R-value. R- R-_ ©Compiles See the Envewpe Assemblies 402.2.1. ❑ Wood ❑ Wood [Does Not table for vahm 402'2.2, ❑ Steel ❑ Steel (]Not Observable 402.2.6 (Fill' [Not Applicable 303.1.1.1, Ceiling Insulation installed per OCompi)es Requirement will be met. 303.2 manufacturer's instructions. [Does Not [FI2)' Blown insulation marked every 300 ft=. ©Not Observable [Not Applicable 402.2.3 Vented attics with air permeable [Complies Exception:Requirement is [F122)2 insulation include baffle adjacent [Does Not not applicable. to soffit and eave vents that extends over Insulation. [Not Observable []Not Applicable 402.2.4 Attic access hatch and door R- R- Momplies Location on plans/spec: (F131' insulation alt-value of the ODoes Not not applicable adjacent assembly. ONot Observable ©Not Applicable 402.4.1.2 Slower door test @ 50 Pa.<=5 ACH 50= ACH 50= Complies Requirement will be met. [Fi171' ach in Climate Zones 1-2,and [Does Not <=3 ach In Climate Zones 3-8. ONot Observable [Not Applicable 403.2.3 Duct tightness test result of<-4 cfm/lo0 cfml100 OComplies Exception.All ducts and air [Fi41' cfm/100 ft2 amass the system or K£ ft2 []Does Not handlers are located within <=3 cfm/100 ft2 without air conditioned space. handler @ 25 Pa.For rough-In ONot Observable tests,verification may need to [Not Applicable occur during Framing inspection. 403.3.2 Ducts are pressure tested to cfm/100 cfm/100 [Complies Exception:All ducts and air [F1271' determine air leakage with ft2 ftp— [Does Not handlers are located within either.Rough-fn test:Total conditioned space. leakage measured with a Ts'laNULu'ikwssocu►T$s INC. [Not Observable pressure differential of 0.1 Inch M3CHUM OR ONot Applicable w.g.across the system including UXIIART,M 40" the manufacturer's air handler st.*si MassncIsEM enclosure if installed at time of A,=N *d E"Wu~an° test.Postconstruction test:Total kmP°C1°"" "y leakage measured with a pressure differential of 0.1 Inch DSW SEMMIMR 05,MIS w.g.across the entire system „ade: �.. « Including the manufacturer's air handler enclosure. ` 403.3.2.1 Air handler leakage designated Ckompliies Requirement will be met. [F12411 by manufacturer at<=2%of [Does Not design air flow. ONot Observable [Not Applicable 403.1.1 Programmable thermostats [Complies Requirement will be met. [Fi41z installed for control of primary 0Does Not heating and cooling systems and initially set by manufacturer to [Not Observable code specifications. nNot Applicable 403.1.2 Heat pump thermostat Installed plies Requirement will be met. [FI1012 on heat pumps. []Does Not [Not Observable [Not Applicable 403.5.1 Circulating service hot water [Complies Requirement will be met. [FI1112 systems have automatic or [Does Not accessible manual controls. [3 Not Observable []Not Applicable 1 I High impact(Tier 1) 2 Medium Impact(Tier 2) 3 1 Low Impact(Tier 3) Project Title:Sparkle Residence Report date: 08/20/18 Data filename:C:\Users\ccraft\Documents\018 CLIENT FILES\Misc.Projects\res check 17013 Page 8 of 10 Sparkle.l.rck sect'ooPlans Verified Field Verified # insulation inspection Value Value Complies? Comments(Assumptions &R .1D 303.1 All installed Insulation is labeled nComplies Requirement will be met. CIN1312 or the installed R-values j]ooes Not provided. - pNot Observable ❑Not Applicable 402.1.1, Walt insulation R-value.If this is a R- R- OComplies See the Envelope Assemb#es 402.2.5, mass wall with at least 1h of the Wood Wood ❑Does Not table for values. 402.2.6 wall insulation on the wall ❑ Mass !Ness (]Not Observable i,IN31' exterior,the exterior insulation requirement applies(FR10). Steel steel CJNOt Applicable 303.2 Wall Insulation Is installed per OComplies Requirement will be met, (IN411 manufacturer's instructions. ❑Does Not []Not Observable ONot Applicable AddMonai Comments/Assumptions: T.R ARNOLD t ASSOCIATES,INC. 4793 CHESTER HR ELKHART,HI 46516 ' statets) MASSACWJSETTS Accredited Evaluation and Inspection Agency Ttisda--tis..16Wasneey mnmane eah sate B d*v cad". Date SEPTEMBER 00.2015 ,qwr orae.aa,..o.a.ea na.aadm>ecr.wa �aamiw a eaa.do-,rmmma aetu:d„e,ecor son t.es 1 High Impact Mer 1) 12 Ifiledium Impact(Tier 2) 13 JLow Impact Cher 3) Project TlUe:Sparkle Residence Report date: 08/20118 Data filename: C:\Userslccraft\Documents1018 CLIENT FILES1Misc.Projects\res check 17013 Page 7 of 10 Sparkle.l.rck I Additional Comments/Assumptions: T.R MWOLD i ASSOCIATES,INC. 6903 CRESTBR DR ZLKKART,IN 46536 States) MASSACHUSETTS Accredited Evaluation and inspection Ager" Tis dla is cxr W as bmV in corl«ma-s +sah Shin&Adb+a caries. Date SEPTEMBER 05,WIS Appovai d a'6 dovtdt does+q.«tiviee«arypwe nq�«AeWnlooeamae n:quinene�la d SYb i.ews. 1 High Impact{Tier 1) 2 Medfum Impact(Tier 2) 3 Low Impact(Tier 3) Project Title:Sparkle Residence Report date: 08/20/18 Data filename: C:\Users\ccraftlDocuments\018 CLIENT FILES\Mise.ProjectsWes check 17013 Page 6 of 10 Sparkie.l.rck i I Section Pians Verified Field Verified # Framing/Rough-In inspection Value Value 'Complies? Comment%/Assumptfons &Req.ID 442.1.1. Door tf-factor. U-^ U-- uComplies See the FrrveiopeAssemblies 402.3.4 0Does Not table for vahtea [FRlji []Not Observable ONot Applicable 402.1.1, Glazing U-factor(area-weighted U- U- Complies See the Envelope Assemblies 402.3.1, average). DDoes Not table for values. 402.3.3, 402.3.6, ONot Observable 402,5 uNot Applicable (FR211 303.1.3 U-factors of fenestration products DComplies Requirement will be met. [FR411 are determined in accordance DDoes Not with the NFRC test procedure or taken from the default table. ONot Observable ONot Applicable 402.4.1.1 Air barrier and thermal barter DComplies Requirement will be met. (FR23I1 installed per manuracturer's DDoes Not Instructions. TM ARNOLD A ASSOCIATES.INC. ONot Observable 4MCHUT$RDR UXHAW,M 4016 uNot Applicable 402.4.3 Fenestration that is not site built sem} IMMUCROW.43 uComplies Requirement will be met. (FR2011 is listed and labeled as meeting Accredited Evaluation and ODoes Not AAMA/WDMA/CSA101A.S.21A444 " "YO"Agency or has infiltration rates per NFRC 'Ah ONot Observable 400 that do not exceed code Dace SEPTEMBER 05,tors ONot Applicable limits, 402.4.5 IC-rated recessed lighting fixtures I DCompiies Exception:Requirement is [FR1612 seated at housing/interior finish DDoes Not not applicable. and labeled to Indicate s2.0 dm leakage at 75 Pa. ONot Observable ONot Applicable 403.2.1 Supply and return ducts in attics uComplies Exception:Duds located (FR1211 insulated>=R-8 where duct is DDoes Not completely inside the >=3 Inches in diameter and>= building envelope. R-6 where<3 Inches.Supply and []Not Observable return ducts in other portions of ONot Applicable the building insulated>-R-6 for diameter>=3 Inches and R-4.2 for<3 inches in diameter. 403.3.3.5 Building cavities are not used as uComplies Requirement will be met. (FR1513 ducts or plenums. DDoes Not ONot Observable ONotApplicable 403.4 HVAC piping conveying fluids R-� R- .DComplies Requirement will be met. [FR1712 above 105 4F or chilled fluids uDoes Not below 55 QF are insulated to eR- 3 uNot Observable DNot Applicable 403.4.1 Protection of insulation on HVAC uComplies Requirement will be met. [FR2411 piping. DDoes Not ONot Observable ONot Applicable 403.5.3 Hot water pipes are insulated to R- R- Complles Requirement will be met. (FR1812 2:11-3. DDoes Not ONot Observable ONot Applicable 403.6 Automatic or gravity dampers are DComplies Requirement will be met. [FR1912 installed on all outdoor air DDoes Not intakes and exhausts. ONot Observable uNot Applicable 1 High Impact(Tier i 2 Medium Impact(Tier 2) 3 1 Low Impact(Tier 3) Project Title: Sparkle Residence Report date: 08120/18 Data filename:CAUserskcraft\Documents\018 CLIENT FILES1Misc.Projectslres check 17013 Page 5 of10 Sparkle.l.rck Section Pians Verified Field Verified # Foundation Inspection Value Value Complies? CommentslAssumptions & Re .ID 402.1.1 Conditioned basement wag R- R- []Complies See Me EavNopeassemblies (F0413 insulation R-value.Where interior R- R-� []Does Not table for vaklea. Insulation is used,verification — may need to occur during []Not Observable Insulation Inspection.Not ONot Applicable required In warm-humid locations in Climate Zane 3. 303.2 Conditioned basement wag QCompfies Requirement will be met. (FOS)' insulation installed per []Does Not manufacturer's instructions. ONot Observable []Not Applicable 402.2.9 Conditioned basement wall ft ft []Complies See the Envelope Assemblks (F06)1 insulation depth of burial or QDOes Not table for vahms, distance from top of wall. []Nat Observable []Not Applicable 303.2.1 A protective covering Is installed []Complies Requirement will be met. (F011)Z to protect exposed exterior []Does Not insulation and extends a []Not Observable minimum of 6 in,below grade. ©Not Applicable 403.9 Snow-and ice-melting system []Complies Exception:Requirement is (F01213 controls Installed. []Does Not not applicable. []Not Observable []Not Applicable Additional Comments/Assumptions: T R ARNOLD a ASSOCIATES,INC. 4743 CHESTER DR ELKHART,IN 4016 state(s) MA8SA*PJSETts A=ediled EWuatim and inspection Agency . This don.nmt u-WW-b-V in—dbm '*'Sate&A*9 Godes. Date SEPTEMBER 40.2416 ary a,.saia,adedamee,emerea.a,traa Stxs loos, 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Law impact(Tier 3) Project Title:Sparkle Residence Report date: 08/20/18 Data filename:C:JUserslccraft\Documents1018 CUENT FILES1Misc. Projeckslres check 17013 Page 4 of 10 Sparkle.l.rck REScheck Software Version 4.6.4 Inspection Checklist Energy Code: 2015 IECC Requirements: 97.0%were addressed directly in the REScheck software Text in the'Comments/Assumptions"column is provided by the user In the REScheck Requirements screen. For each requirement,the user certifies that a code requirement will be met and how that is documented,or that an exception Is being claimed.Where compliance Is Itemized In a separate table,a reference to that table Is provided. Section Plans Verified Field Verified # Pre-Inspection/Plan Review Value Value Complies? Comments/Assumptions &Req.ID I I 1 1 103.1. Construction drawings and [Complies Requirement will be met. 103.2 documentation demonstrate ODoes Not JPR112 energy code compliance for the building envelope.Thermal ONot Observable envelope represented on 014otApplicable construction documents. 103.1. Construction drawings and OComplies Requirement will be met. 103.2, documentation demonstrate ©Does Not 403.7 energy code compliance for [PR311 lighting and mechanical systems. 0Not Observable Systems serving multiple 13Not Applicable dwelling units must demonstrate compliance with the IECC Commercial Provisions. 302.1, Heating and cooling equipment Is Heating: Heating: Ekomplies Requirement will be met. 403.7 sized per ACCA Manual 5 based Btu/hr BtWhr 13Does Not [PR2)2 on loads calculated per ACCA Cooling: Cooling: []Not Observable Manual J or other methods BW/hr Stuffir approved by the code official. [3Not Applicable Additional Comments/Assumptionst TA AMOLD&ASSOCIATIM INC 4793 CHESTER DR ELKHART,M 4016 state(s) MASUCIMETTS Accredited Evaluation and Inspection Agency ...ti—W1ed-b*Vk—*— vAh%a%&A&V Codex pate worommmoka"s sues tws. I I 1High Impact(Tier 1) 12 1 Medium Impact(Tier 2) 13 [Low Impact(Tier 3) Project Tittle: Sparkle Residence Report date: 08/20/18 Data filename: C:\Users\ccraft\Documents\018 CLIENT FILES\Misc.Projectskres check 17013 Page 3 of 10 Sparkle.l.rck TA ARNOLD&ASSOCIATES,INC. 47OCKESTEROR ELKHART,W 46516 sn,Ws) MA88JACHUSETTS Accredited Evaluation and Inspection Agency %h domtten i,-triad as b&V m cmt- .ia sada C.de. Arte SEPTEMBER 06,ME Slab leas Project Title;Sparkle Residence Report date. 08/20/18 Data filename. C:\Users\ccraft\Documents1018 CLIENT FILESkMisc.Projects\res check 17013 Page 2 of 10 Sparkle,l.rck T.R AMOMa ASSocu+TM nYc. 4M CHESTER DR saim RT.DV 46516 REScheck Software Version 4.6.4 oaf., MASSACHUSETTS AccreMed Evaluation and Inspection Agericy Compliance Certificate YA Lvi ..a sL.e.Leap cud . Date SEPPTEMSEH 06,M8 lq.wd d tlM do¢risd Arn ad wlydle a appme sry o.*.W-n dwd *—ae rc¢iennRsd Slab Lars Project Sparkle Residence � Energy Code: 2015 IECC y%A OF MAS Location: Northampton, Massachusetts 2��A SqC Construction Type: Single-family KEVIN M.oyG Project Type: New Construction FINN m CIVIL Conditioned Floor Area: 2,815 ft2 pNo.39636 2 Glazing Area 8% Q Climate Zone: 5 (6404 HDD) �� STS Permit Date: FF 0 Permit Number: Construction Site: Owner/Agent: Designer/Contractor: GROVE AVE STEVE DAVIS LEEDS VERMOD HOMES LLC NORTHAMPTON,MA 01060 P.O.BOX 566 2677 RT 5 WILDER,VT 05088 802-295-0042 steve@vermodhomes.com lellrltlN: Compliance: 51.39E eetteir Than Code Maximum UA: 302 Your UA: 147 The%Better or worse Than Code Index reflects tow dose to compEance the house is based on core trade-off rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum code home. Envelope Assemblies F- Gross Area Assembly or Cavity Cont. U-Factor UA i Ceiling 1:Structural Insulated Panels(SIPS) 787 60.0 0.018 14 Ceiling 2:Fiat Ceiling or Scissor Truss 234 60.0 0.0 0.024 6 Wall 1:Other Framed Wail 2.279 0.023 52 Wall 2:Insulated Concrete Forms 520 40.0 0.027 6 Window 1:Vinyl/Fiberglass Frame:Triple Pane with low-E 233 0.200 47 Door 1:Solid 63 0.120 8 Basement Wall 1:Insulated Concrete Forms 520 40.0 0,026 14 Wall height:8.0' Depth below grade:4.0' Insulation depth:8.0' Compliance Statement: The proposed building design described here is consistent with the building plans,specifications,and other calculations submitted with the permit application.The proposed building has been designed to meet the 2015 IECC requirements in REScheck Version 4.6.4 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Name-Title Signature Date Project Title:Sparkle Residence Report date: 08/20/18 Data filename:C:Wsers\ccraft\Documents1018 CLIENT FILES1Misc.Projects res check 17013 Page 1 of 10 Sparkle.Lrck �h t MANUFACTURER'S DATA PLATE FACTORY INSTALLED EQUIPMENT EQUIPMENT IN ANUFACTURER MODEL NO. Manufacturer VERMOD HIGH PERFORMANCE MODULAR HOMES.GLC Heating BY BUILDER Address 2677FIARTFORDAVE coding BY BUILDER City,State,Zip WHITE RIVER JCT,VT 05001 RangelBunter BY BUILDER LISTED INDUSTRIALIZED BUILDING Own BY BUILQER Madel 4 BOX-2 STORY wiigmtm BY BUILDER Occupancy Classification R-3 Const.Chtss VB w wHeater BY BUILDER MatlafactuvwsserwNo(q 18079A, 18079B, 180790, 18079D Disbwasim BY BUILDER Dale of Manufacture PI.Approval No. Disposal N/A Date Data Plate Attached Hydro-MassageTub BY BUILDER Penrussibte Gas Type(s) NIA Electric Rating 200 AMP Test Voksi;clTime 1080 VOLTS FOR 1 SECOND Water Supply:Test Procedure 100 PSI FOR I MINUTE Floor Design Live Load 40 PSF Design Wind SP-d i 17 Vult EXP B Sbi in Wa t s And Exposure PP g gh() Ground Straw Load 40 PSF R'Lit 35 PSF TRA Label No(s). Exterior Wall Fire Rating 0 Seismic Design C State Insignia No(s). Winter Design 1ranp.:inside 700 Outside -200 Uo: Ceiling R-60 Wali R 43 Floor R_Q Fdtew precisciy di insimcd ss wkh chis building Fuuudatient,Gttallatiau and DiNity Ctnmections are subject t*iupectiew by teed uubakiu. CODE REFERENCE PLATE l THIS MANUFACTURED STRUCTURE HAS BEEN CONSTRUCTED IN CONFORMANCE WITH THE FOLLOWING CODES: PCN OF MA'S © 2017 NATIONAL ELECTRICAL CODES ❑ INTERNATIONAL BUILDING CODE KEVIN M. G ❑ INTERNATIONAL MECHANICAL CODE FINN m ❑ INTERNATIONAL PLUMBING CODE CIVIL Q 2015 INTERNATIONAL ENERGY CONSERVATION CODE N0.39636 ❑+ 2015 INTERNATIONAL RESIDENTIAL CODE ❑ INTERNATIONAL FUEL GAS CODE 'Qp� S ❑ INTERNATIONAL FIRE CODE tr 4,N ❑ UNIFORM BUILDING CODE ❑ UNIFORM PLUMBING CODE ❑ UNIFORM MECHANICAL CODE ❑ NATIONAL STANDARD PLUMBING CODE 13 0 7m CWR Si.aa Massxhesuts Raidemisi todr TA ARNOLD t ASSOCIATES,INC. © 780 CMR 119 Appco&x AA Stretch Energy Cade 470.1 C<4RSTLR DB ❑ gLKBAIM.U4 46616 ❑ statets) MASSACHUSEWS ❑ Accredited Evduanon and ❑ man Ag-Ly ❑ Tt"d... t m w bAW ac bine ncort-- wlh S&n**Q Codes. ❑ Date SSR 05,M8 rys.e..'asss.aaaba dose noc wuodae a aprywe Nq mk W m ar d.M..can de n4�of swe t.ws VERMOD LLC SUBJECT:WOOD HEADER CALC Erqkxm: Kevin M.Finn,P.E. WILDER,VT 2012 NDS 815 Waterbury Park Drive Elkhart,IN 46517 MA LIC NO.39636 THIS CALCULATION IS AN ANALYSIS/DESIGN OF A SIDEWALL HEADER. ALL PARAMETERS OF THE DESIGN ARE INDICATED AS SUCH. PROGRAM DETERMINES THE MAXIMUM CLEAR SPAN (L). 9TH EDITION OF MA BUILDING CODE 12015 ISC/ASCE 7-10 SITE CONDITIONS- FLOOR LIVE LOAD a 30 PSF TRIBUTARY WIDTH FROM 2ND FLOOR= 57 IN TOTAL DEAD LOAD= 10 PSF MAXIMUM WIND UPLIFT CONDITION-115 MPH,EXP.C UNIFORM LOAD m;(LIVE+DEAD)x UNIT WIDTH m,W e, 190.0 P" =16.8 P11 MATERIAL&PHYSICAL PROPERTIES- DL ONLY W a m;15.8 pli DBL 2 x 10 SPF#2 TRIMMER ON EDGE REACTION OF LVL HEADER-CLEAR SPAN = 132.5 IN t (n) = 3.0 z 1048.96 LBS dQn) e, 9.3 to(W4) w 247.3 w/DECKING Sx OnA3)= 53.5 54.00 In a132.500 IN b (in)= 1.5 A A (W2)- 27.8 Ac(W2)= 2.3 U E(psQ- 1400000.0 102.0 in HEADER ALLOWABLE SPAN BASED ON BENDING Fb(psQ= 875.0 P me 1048.96 LBS Fv(psi)- 135.0 V* = 63.33 PLF Fq-(psQ= 425.0 TRIMMER FW =FbxCDxCrxCF - 962.6 PSI CO(flf)= 1.0 Ib z Pab/(4L x(Sx)+WtrLA21(8 x Sx) CF 1.0 w m 945.392 PSI Cr = 1.1 TRIMMER CLEAR SPAN ALLOWABLE SPAN BASED ON DEFLECTION 156 IN 6 a 0.295 IN VS.LIM= 0.43333 IN OF Mgss At SPAN WED ON SHEAR Fv' - Fv x CD Iv = 1.5(P+W(L-2d)Y(2 x A) at 51.3677 PSI EMVIN 0 KKFINN us 12 CIVIL y0 No.39636 U�o,¢SG'S ��4 � ON T.R ARNOLD It ASSOCUM.INC. 4763CHESTER DR ELKHART,IN 46516 state(s) MASSACHUSETTS Accrecked Evaluation and Inspection Agency ThS donanuR e.WAW as b&Vkl-rd-- .0 SWR&4612 COM Dale SEPTEMBER OS,2018 App—A d C 4aamnt does m&*Ww aPP— .'e ft F* d ==L-77!—I Commonwealth of Massachusetts Manufactured Buildings Program-Plan Identification Number Assignment Name of Manufacturer VERMOD HIGH MC Identification Number 566 PERFORMANCE HOUSING Third Party Identification Number 03 Project Title Unit # 18079 Use Group R3 BBRS\OPSI I Identification Number 0339-149 Review Required All plans are reviewed by MA and a BBRS Number assigned when approved I Date:09/ 19/ 18 Manufactured Buildings Program From: Linda Shea Manufactured Buildings Program Re: Confirmation of Receipt of Building Plans &Assignment of BBRS\OPSI Identification Number (BBRS\OPSI I.D. Number) The Board of Building Regulations and Standards and Office of Public Safety (BBRS\OPSl)has received your building plans for the referenced project and has assigned the identification number noted above (in the block marked BBRS\OPSI I.D.Number). This number has been assigned for purposes of internal tracking methods. This number shall be used in reference to this project and on all future correspondences,inquiries and plan revisions. Thank you for your cooperation with this matter. Send all correspondences,inquiries and plan revisions to: Office of Public Safety&Inspections-Linda Shea 1000 Washington Street,Suite 710 Boston,MA 02118 Linda.shea@mass.gov Bbrs\forrns2\manufacturedbldgplanid-06/2018 1 Commonwealth of Massachusetts .Manufactured Buildings Program Transmittal Form for all correspondences relating to Manufactured Buildin and Building Compo To: Linda Shea,Manufactured Buildings Program Phone Number: Date Transmitted Linda.shea®state.ma.us 508-422-1955 09-05-18 Commonwealth of Massachusetts 50 Maple Street Board of Building Regulations and Standards Suite One Milford Massachusetts 01757-3698 The person forwarding material shall complete the following portion of this transmittal. Please print clearly or type required inforrnalion. Name of Person KEVIN J. WHITE MC Number 566 TPIA Number 03 TransmittingMaterial The following information is being transmitted to the Board of Building Regulations Please indicate the Distinct Use And Standards and\or the Department of Public Safety for reasons detailed below Model andlor Serial Group (Please check the appropriate box or give a further description of the transmitted Number pertaining to Items under the section labeled other. Be sure to iden!a the appropriate Use Group.) transmitted items. Building plans for review and approval Building plans forwarded as a record copy for your files(review not Unit #18079 R-3 required). Revised building plans for review. (Please dearly identify revisions on the fans. Revised building plans forwarded as a record copy for your files review not required-Please clearly identify revisions on the ns. When submitting materials identified below,please ensure that you clearly indicate modifications to each pages). Also,please indicate the BBRS\DPS Identification Number on all applicable materials. Modifications to p fpgrams manuals or drawings shall be accompanied by an index which clearly identifies which pages are to be nem ved and which vages are to be laced Check thea 'ate box for materials transmitted. Compliance Assurance Programs Original submission Modification to: Calculations Manual Original submission Modification to: Installation Manual Original submission Modification to: Systems Drawings Original submission Modification to Other-Provide a detailed description of any other materials which are being transmitted. Identify any revisions clearly along with BBRS No. Also,identify the requested action. Site Location: 87 Grove Ave-Leeds MA The office transmitting this information has reviewed the above mentioned and attached materials and has found them,to the best of our knowledge and abilities,to be in compliance with the codes and\or rules and regulations for the Commonwealth of Massachusetts'Manufactured Building program,as applicable. Signed by: Bate: IVJ6�� 09-05-18 mf forms mf transmittal-Revised April,21)15 N8443'21"E 169.19' 15.0' s o 1 SETBACK v __- o '- 20.02' 87 GROVE AVE. r'. ' I- S It W-k - 11 kuy C' HORIZONTAL SCALE -30 0 15 30 60 (IN FEET) 1 INCH= 30 FEET 87 GROVE AVE JOB: 2015.02 LEEDS, MA 01053 DATE: 10.30.18 Zengineer civil engineering PLOT PLAN 378 MAIN STREET,#2,EASTHAM"ON,MA 01027 PLOT- 1 www.theZengineer.com 1 (617)271-4004 MUNICIPAL WATER AVAILABILITY APPLICATION Northampton Water Department 237 Prospect St. Northampton, MA 01060 413-587-1097 A Department of Public Works Trench Permit shall be required prior to any construction or connection activity associated with this application. Location: 87 Grove Ave, Leeds,14A dry Made By: BucSparkle 617-271-4004 (Name) (Telephone Number'; te of Inquiry: 5/2/2017 Fire Line Irrigation Domestic fiber of Units: 1 Type of Units: Type of Ownership: Single Family x Private x Apartments Condo Muli-Family Rental Commercial (Applicant to fill out the above) Municipal Water Main in Front of Location: Yes No X Existing service to site Yes No X Size of Water 1V 6" Material: Cl Age:_1930 Approximate Static Street Press 40 PSI Flow Test Conducted: Yes Nol (If flow test conducted attach rest].ts) Size of Service Connec 1"copper Suggested Meter Size: — 111 amments: The Water Department cannot guarantee adequate water pressure 4gVLnA___ peak demand times at elevations above 320' ****LOWER PRESSURE"" Water main ends at last hydrant,service line can connect but is owners reilp(Insibilitj - A cot-responding water enterance fee shall be paid prior to making any connection to the inunicipa water system. -Arrangement of such installation shall be made with the Northampton Water Department within a minimum of 5 working days notification. -All work shall conform to Northampton Water Department specifications. ANDREW DUNN 5/4/2017 (Water Superintendent) (Date) Water Entry$ 200 Meter$ 180 Radio Read$ 135 cc: City of Northampton Building Dept./Commissioner Total $515.0G NOTE- If this availablitiy is for a new construction,it must be hand delivered to the Building Inspector MUNICIPAL SEWER AVAILABILITY APPLICATION Northampton Streets Department 125 Locust Street Northampton,MA 01060 413-587-1570 A Department of Public Works Trench Permit and Sewer Entry Permit shall be required prior to any construction or connection activity associated with this application. Location: 87 Grove Avenue, Leeds, Ma 01053 Date of Inquiry: 05/02/17 Inquirer with contact info: Bucky Sparkle/The Zen ineer 617-271-4004 Reason for Request: New Construction --- Hook into City Sewer IV.unicipal Sewer Main in Front of Location: Yes J No Size of Sewer Main: I Material: A C Age: Death of Sewer Main: -LA! Length of Sewer Main: 145 Siz� of Service Connection: Type of Service Connection: /44i Tie-in to Sanitary Tie-in to Sanitary Stub: Tie-in to Private Sanitary: Tie-in to Existing Sanitary Service: Comments: . Cit Line y Requires " cleanout installed at City Property Note:If this availability is for ne construction,this form must be hand delivered to Building Inspector. A corresponding"sewer ent T prance fee"shall be paid prior to making any connect'o)I t0 the municipal sewer systeml Arrangements of such intstallation shall be made wil:h the I Northampton Streets Department with a minimum of 5 working days notificaiton. P 11 work i shall conform t6 Northampton Streets Department specifications. Date: Sewer Dept. Foreman Sewer Entry$ l t < U y VL r Rk2v/ { " _ iwrit�m� Permit No. D17-17 CITY OF NORTHAMPTON,MA DRIVEWAY PERMIT Date: 4/2:)*/: 7 FEE: S250.00 Check#: 504�._ Proposed driveway must be staked and address and or lot number Hosted Public Shade l-ees are protected by MGL Chanter 87. Do not cut,trim or remove any trees on City prod:erg: The undersigned respectfully petitions your honorable body for: A NEW CURBCUT Pe_�nission to install a driveway at: 87 GROVE AVE, LEEDS,MA 01053 UT- Fifteen(15)foot maximum width from street line to property line. Gutter drainage not to b: disturbed. All drainage shall be directed off the driveway surface to adjacent land and nol cf 1 the existing roadway. The first one hundred(100)feet of the driveway surface shall be p&%,1-,d an soon as possible if the grade of the proposed driveway exceeds 3%at any point in the fir<i o:ie hundred(100)feet. Homeowners will be held responsible for any costs to the City of Northampton in the event of a washout of this driveway. City is not responsible for culvert; installed under driveways in City layout. Code of Ordinances §350-8.8 providing standard,;for private., individual driveways as most recently amended, must be followed. O NBy: Bucky Sp2ode/The 2enkineer Telephone: 617-271-4004 �----- Proposed Location Inspection By:�` Graver Base Grade Inspected By: Final A-pproval: Director of Public Works Cc:: Building Inspector File#W-2017-0048 APPLICANT/CONTACT PERSON SPARKLE EMILY r WIC ADDRESS/PHONE 378 MAIN ST (508)793-1332 0 PROPERTY LOCATION 83 GROVE AVE MAPIPARCELS OP-WILZONE LURWIM THIN SECLION Mg QfELQ&USE ONLY: PERMIT AVIXA11-0-S CIMMM ENCLOSED REQUIRED DATE &(&N2K FORM FUUD OUT Foe Paid Fee Pow Construction: A&-P&MSED SINGLE New CQWU119i6 AOifim to&Wmg A!!NNM all!&W Dli&&Pi=1WJMd4 Quff(&MUMA W_License 3 sets of Plans/Plot Plan THE FPLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON IN,FgAMATION PRESENTED: .V Approved Additional permits req"(see below) A� At-4TO Tf Wr R4Vt6%#Q Ats'd Po - awk 'J'". PLANNING BOARD PERMIT REQUIRED UNDER:§ C)NSVZiFAJrt6A CorArAdSf"3 intermediate Project: Site Plan AND/OK Special Permit with Site Plan F Major Project She Plan AND/OR _�Special Permit with Site Plan i N °Rpt tom ZONING BOARD PERMIT REQUIRED UNDER§ Fin din&_ Special Permit Variance* Received&Rea rded at Registry of Deeds Proof Enclosed Other Permits Required:- V., Curb cut from DPW u,,*'Water Availability Sewer Availability � c Approval Board of Health Well Water Potability Eloard of Health Permit from Conservation Commission Permit from CR Architecture,Committee —permit from Elm Suva Commission Permit DPW storm Water Management Signature of Building OlEcisl . Date Note:issuance of it Zoning permit does not relieve a applicant's burden to Comply With all Ming requirements and obtain all required permits from Board of Health,Conservation Commission,Department of public works and other applicable permit granting atftoritiaL Vniaum we granted only to those applicants who meet the strict standards of MGL 40A.Contact the Office Of Planing&Development for more infomutim City of Northampton Massachusetts r DEPAR"OW OF BUILDnfG INSPECTIONS 212 Malin Street s Municipal Building Northampton, MA 01060 Fee Calculator for Residential Properties Location : 87 Grove Ave, Leeds, MA 01053 Square Footage Amount Basement @ .20 (previously permitted) 1 sT Floor @ .50 1061 $530.50 2"d Floor @ .50 792 $396.00 Y2 Floors, Finish Attic, Garage @ .20 Deck / Porches @ .20 245 $49.00 Total $975.50 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However,the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply your insurance company's name,address and phone number along with a certificate of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required.Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number.In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary). A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture(i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street Boston,MA 02114-2017 Tel.#617-727-4900 ext. 7406 or 1-877-MASSAFE Fax# 617-727-7749 www.mass.gov/dia Form Revised 02-23-15 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An enrployer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to cant'workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston,MA 02114-2017 Tel.#617-727-4900 ext. 7406 or 1-877-MASSAFE Fax#617-727-7749 Revised 02-23-15 www.mass.gov/dia The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street,Suite 100 Boston,M4 02114-2017 T www mass gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name(Business/Orgw&ationtlndividual): Emily Sparkle Address: 378 Main Street,#2 City/State/Zip:Easthampton, MA 01027 Phone#:608.783.1332 or 617.271.4004 Are you an employer?Check the appropriate box: Type of project(required): 1.Q I am a employer with employees(full andlor part-time)-* 7. New construction 2.❑1 am a sole proprietor or partnership and have no employees working for me in S. Remodeling any capacity.[No workers'comp.insurance required.] 3.[✓ I am a homeowner doing all work myself.[No workers'comp.insurance required.]+ 1 ❑Demolition 10 Q Building addition 4.O I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑1 am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These subcontractors have employees and have workers'comp.insurance.: 0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.[:]Other 6. 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#I must also fill out the section below slowing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information- Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do here ce r the nd penalties of perjury that the information provided above is true and corrects, Si store: 04 r Date: 10/30/18 Phone 4,: 508%31332 6 617 271.400y Official use only. Do not write in this area,to be completed by city or town official. City or Town: PermitlLicense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#• City of Northampton _ " . Massachusetts � . t DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street a Municipal Building �y. p Northampton, MA 01060 Debris Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. The debris from construction work being performed at: 87 Grove Ave., Leeds, MA 01053 (Please print house number and street name) Is to be disposed of at: Valley Recycling, 234 Easthampton Rd., Northampton, MA 01060 (Please print name and location of facility) Or will be disposed of in a dumpster onsite rented or leased from: (Company Name and Address) �acv_[ <��C)A-Af— 1,C) Signature of Permit A plicant or Owner Date If, for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the Building Department as to the location where the debris will be disposed. City of Northampton Massachusetts ' ZWARTbEWT OF BUXZDING INSPECTIONS ? Ufa 212 Main Street • Municipal Building Northampton, MA 01060Y jl^ Massachusetts Residential Building Code Section 110.R5.1.2 Homeowner: Person(s)who own a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Section 110.R5.1.3.1 Any homeowner performing work for which a building permit is required shall be exempt from the licensing provisions of 780 CMR 110.85, provided that if a homeowner engages a person(s) for hire to do such work,then such homeowner shall act as supervisor. Such homeowner shall submit to the Building Official, on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152 (Workers' Compensation)and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you may be liable for person(s)you hire to perform work for you under this permit. City of Northampton 00 Massachusetts fF Y ' ZZPAR4MENT OF BUXZDIIPO ZNSPro=ZOPS 212 Main $tr"t • Municipal Building Northampton, MA 01060 AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application The Office of Consumer Affairs and Business Regulation("OCABR")regulates the registration of contractors and subcontractors performing improvements or renovations on detached one to four family homes.Prior to performing work on such homes,a contractor must be registered as a Home Improvement Contractor("HIC"). M.G.L. Chapter 142A requires that the"reconstruction,alteration, renovation, repair, modemization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building"be done by registered contractors. Note:If the homeowner has contracted with a corporation or LLC,that entity must be registered. Type of Work: New single-family residence Est.Cost: $370,000 Address of Work: 87 Grove Ave., Leeds, MA 010553 Date of Permit Application: 10/30/18 1 hereby certify that: Registration is not required for the following reason(s): Work excluded by law(explain): T Job under$1,000.00 X Owner obtaining own permit(explain): The owner is applying for the permit Building not owner-occupied T Other(specify): OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER M.G.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION. Signed under the penalties of perjury: I hereby apply for a building permit as the agent of the owner: Date Contractor Name HIC Registration No. OR: Notwithstanding the above notice,I hereby apply for ermit as the owner of the above property: 10/30/18 Emily Sparkle Date Owner Name and Sign SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable IX Narne of License Holder t.icense Number Address Expiration Date Signature Telephone S 'Re isten d Hesrne ImproVeMNA Cc►rttr GIM, ' Not Applicable X Company Name Registration Number Address Expiration Date -Telephone SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application.Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes....... X No...... ❑ SECTION 5-DESCRIPTION OF PROPOSED WORK(check all aunlicable) New House Q Addition M Replacement Windows Alteration(s) Roofing ❑ Or Doors ❑ Accessory Bldg. ❑ Demolition ❑ New Signs [1:3] Decks [M Siding[O] Other[CQ Brief Description of Proposed Setting modular structure,finishing interior,roof&siding;installing driveway Work: Alteration of existing bedroom Yes X No Adding new bedroom Yes X No Attached Narrative Renovating unfinished basement Yes x No Plans Attached Roll -Sheet Ba.If New house and or addition to wMw.ho Al"I c011n111HOW the,folloWina: a. Use of building: One Family X Two Family Other b. Number of rooms in each family unit: 2 Number of Bathrooms 2 c. Is there a garage attached? NO d. Proposed Square footage of new construction. 1853 Dimensions 40'6" X 26'2" e. Number of stories? 1.75 f. Method of heating? ELECTRIC Fireplaces or Woodstoves NO Number of each 0 g. Energy Conservation Compliance. YES Masscheck Energy Compliance form attached? YES h. Type of construction Modular i. Is construction within 100 ft.of wetlands? Yes X No. Is construction within 100 yr. floodplain Yes X No j. Depth of basement or cellar floor below finished grade Walk out basement k. Will building conform to the Building and Zoning regulations? X Yes No. I. Septic Tank City Sewer X Private well City water Supply X SECTION 7a-OWNER AUTHORIZATION-.TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I Emily Sparkle as Owner of the subject property Bucky Sparkle rirdthorize o act o betplf, in u tters relative to work authorized by this building it application. 79L-14, , v Si of Own Date I Bucky Sparkle as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Bucky Sparkle Print ame Sighature of OAer/Ag—ek Date Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot size 31,747 SF 31,747 SF Fmn a 145_ft 145 ft Setbacks Front '20 20 Side L: 15 R: 15 L:`15 R. 15 Rear 20 2Q Building Height 0 21 Bldg.Square Footage 0_ 0 a° 1853 6%_ Open Space Footage 1u `S (Lot ani minus bldg&paved 1853': 6% 4980' 16%, • U14- parking) t4- arkin #of Parkin Spaces 0 3 Fill: NA 90.CY+/- volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DONT KNOW 0 YES 0 IF YES, date issued:' IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES IF YES: enter Book Page and/or Document B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW 0 YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained a Obtained 0 , Date Issued: C. Do any signs exist on the property? YES ® NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO IF YES, describe size, type and location: E. Will the construction activity disturb(dearing,grading,excavation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO e IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Ci of Northampton � � � City P SltrofiG Building Department ii»ulau 4' 212 Main Street ;IeAvahll� Room 100 Northampton, MA 01060 itraf+ phone 413-587-1240 Fax 413-587-1272 APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION bpr (q - 1.1 Property Address: This section to be completed by office Map' Lot Unit 87 Grove Ave., Leeds, MA 01053 zone OverlayDisttict Elm St District CS District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Emily parkle 378 Main Street,#2,Easthampton,MA 01027 NW(PqS Current Mailing Address: �Ck4a_ Telephone 508.783.1332 Signature 2.2 Authorized Aaent: �J ^ 11` O t0 Z \S vc.Ad ��GtiRG `� �� 1 "`c►:J. .��i ` Z) Fq�`t�0.11�1�'�d1il,t� Name(Print) Current Mailing Address: L� T- J Lot-4 - Z-4 1 - 4 O1) -I gnature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building $334,000 (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of $17,000 Construction from 6 3. Plumbing $14,000 Building Permit fee 9 4. Mechanical(HVAC) i�Tif J 5. Fire Protection $5,000/$0 6. Total=0 +2+.3+4+5) $370,000 1 Check Number This Section For Official Use Only Building Permit Number. Date Issued: Signature: Building CommissionerAnspector of Buildings Date EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) 41!the Bucky Sparkle, PE zengineer 378 Main St., #2, Easthampton, MA 01027 civil engineering with a conscience ce 617.271.4004 or zenglneerbucky@gmall.com 30 October 2018 Louis Hasbrouck, Building Commissioner Building Department RECEIVED 212 Main St. Northampton, MA 01060 Ph: 413-587-1240, Fx: 413-587-1272 OCT 3 0 ?O1$ Ihasbrouck@northamptonma.gov DEPT.OF BUILDING INSPECTIONS Project: 87 Grove Avenue, Leeds, MA I NORTHAMPTON,MA 01060 Subject: Transmittal of Building Permit Application Dear Louis, Attached, please find a complete application for a building permit, including all attendant documentation. Please let me know if you have any questions. Thank you. Brightly, uc spar W B cky Sp4kle, PE Attachment: Application to Construct a One Family Dwelling Home Improvement Contractor Law Affidavit Debris Disposal Affidavit Worker's Compensation Insurance Affidavit Fee Calculator for Residential Properties Check #628 for $975.50 Copy of Zoning Permit (Lot was formerly known as 83 Grove Ave. That is our neighbor.) Copy of Curb Cut/Driveway Permit Copy of Sewer Availability Copy of Water Availability Plot Plan Stamped Paper Plans PDF Plan Set (to be sent by email) Massachusetts Manufactured Buildings Program Transmittal Form Massachusetts Manufactured Buildings Program Plan Identification Number Assignment Stamped Wood Header Calculations Manufacturer's Data Plate Code Reference Plate Stamped REScheck Compliance Certificate The Zengineer 1 of 1 °IC File#BP-2019-0533 at,- P �i a-5 APPLICANT/CONTACT PERSON Bucky Sparkle p ADDRESS/PHONE 378 Main St.#2 EASTHAMPTONlie N E� S PROPERTY LOCATION 87 GROVE AVE MAP 05 PARCEL 071 ZONE A �L THIS SECTION FOR OFFIC USE ONL . f PERMIT APPLICAT CHECKLIST ENCLOSED REQUIIIED DATE ZONING FORM FILLED OUT Fee Paid 1-1 IV Building Permit Filled out Vi Fee Paid !ypeof Construction: SETTING MODULAR 1,TR1JC.TkPF TERIO ROOF&SIDING INSTALLING DRIVEWAY New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: Approved Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Permit With Site Plan Major Project: Site Plan AND/OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* Received&Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay 4--- l 6 Signature of Building Official Date Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health,Conservation Commission,Department of public works and other applicable permit granting authorities. * Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of Planning&Development for more information. 87 GROVE AVE BP-2019-0533 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 05-071 CITY OF NORTHAMPTON Lot: - PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:New Single Family House BUILDING PERMIT Permit# BP-2019-0533 Proiect# JS-2018-000601 Est.Cost: $370000.00 Fee: $975.50 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor. License: Use Group: Homeowner as Contractor Lot Size(sq.ft.): Owner: Bucky Sparkle Zoning: Applicant. Bucky Sparkle AT. 87 GROVE AVE Applicant Address: Phone: Insurance: 378 Main St.#2 EASTHAMPTON MA01 027 ISSUED ON.111112018 0:00:00 TO PERFORM THE FOLLOWING WORK.-SETTING MODULAR STRUCTURE, FINISHING INTERIOR, ROOF & SIDING, INSTALLING DRIVEWAY POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Deaartment Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: FeeType: Date Paid: Amount: Building 11/1/2018 0:00:00 $975.50 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner